New Site Rates the Performance of California Long Term Care Services

Report finds increased reliance on home-based services and continued quality challenges

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The California HealthCare Foundation (CHCF) today unveiled a new Web site rating thousands of the state’s long term care providers on a wide range of quality of care measures — information that will help consumers make better choices and focus providers on improving quality.

A new report also released today by CHCF shows that more Californians are searching out home-based long term care services instead of nursing homes, and that despite some areas of improvement, the states’ nursing homes face continued quality challenges.

The free online service,, rates the care provided by nursing homes, hospice programs, and home health agencies, where data is available to evaluate performance. The site also provides information on many other kinds of long term care, such as assisted living, retirement communities, and day care. CalQualityCare features an easy-to-use “Long Term Care Assistant” tool that helps consumers choose among care options by posing ten simple questions.

“There are thousands of long term care choices in California, but the quality of care provided varies from superior to poor,” said Mark D. Smith, M.D., M.B.A., CHCF president and CEO. “CalQualityCare gives consumers the information to help decide which providers will best meet their needs.”

The new CHCF report, Long Term Care Facts and Figures, showed that use of long term care services has increased between 2003 and 2007, with more than one million Californians, including adults, children with disabilities, and the elderly, using some type of long term care service. But most of the growth occurred among people using home and community-based services, while the number of people in nursing homes has remained steady.

“This Web site will allow both consumers and nursing home managers to see how the state’s long term care facilities rate based on important quality measures. It will shine a spotlight on each facility’s quality of care and opportunities for improvement,” said Bonnie Darwin, executive director of the California Culture Change Coalition, a statewide organization representing nursing home providers, resident advocates, state and federal regulators, and direct care workers.

Sponsored by CHCF in partnership with the University of California, San Francisco, CalQualityCare is an independent service with no commercial relationships that might bias ratings systems. The data are collected exclusively from federal and state agencies.

“We believe that if California consumers have this kind of information when making long term care decisions, then providers will be motivated to give better quality care to their patients,” adds Maribeth Shannon, director of the CHCF Market and Policy Monitor Program. “That’s our ultimate goal.”

Other key findings from the Long Term Care Facts and Figures report include:

  • California’s nursing homes have reduced the use of restraints on patients, but the usage rate is still above the national average.
  • California spends $3.8 billion for Medicaid nursing home services, but nursing homes continue to have a large number of serious federal deficiencies, serious state citations and complaints, and rank low on several quality measures compared to the nation.
  • California Medicare beneficiaries use fewer home health and hospice services and have lower expenditures in this area than the national average.
  • California has a higher percentage of Medicaid participants receiving home- and community-based care (80%) than the national average (62%).
  • In spite of recent increases in Medicaid reimbursement to nursing homes, California reimbursement rates continue to lag behind the national average.

Long Term Care Facts and Figures is published as part of the CHCF California Health Care Almanac, an online clearinghouse for key data and analysis examining California’s health care marketplace. Find all Almanac reports at

In addition to, CHCF also sponsors, which provides quality of care information about the state’s hospitals.

About the California Health Care Foundation

The California Health Care Foundation is dedicated to advancing meaningful, measurable improvements in the way the health care delivery system provides care to the people of California, particularly those with low incomes and those whose needs are not well served by the status quo. We work to ensure that people have access to the care they need, when they need it, at a price they can afford.